Meta analysis on prognostic factors of patients with severe hepatitis B

Objective To analyze the risk factors determining the prognosis of severe hepatitis B after HBV infection.Methods Articles about severe hepatitis B published before November 2009 were retrieved and risk factors affecting prognosis of severe hepatitis B such as total bilirubin(TBil),prothrombin activity(PTA),alpha-fetoprotein(AFP),creatinine and hepatic encephalopathy(HE)were summarized.Heterogeneity tests and variables merging were used to count standared mean difference and relative risk in stochastic model.Results Thirteen studies including 2429 patients with severe hepatitis B patients were summarized.In meta analysis,the levels of AFP,PTA,TBil and the incidence of HE in survival group were different from those in death group(P0.001).In meta analysis,heterogeneity were tested in AFP,PTA,TBil and the heterogeneity were not decreased by subgrouping and meta-regression analysis.Conclusions There were homogenously significantly differences in occurrence of HE and increased creatinine between survival group and death group.The levels of PTA,TBil and AFP show significantly heterogeneity which might originated from other excluding criterion such as cirrhosis,coinfection with other virus and habitual alcoholic intake.Diagnostic criteria for severe hepatitis B to HBV infection should include a set of prognostic factors(PTA≤ 40%,TBil10 times of normal level)and also exclude some potential factors influencing prognosis of severe hepatitis B.